实用心电学杂志2024，Vol.33Issue(2)：141-150,10.DOI:10.13308/j.issn.2095-9354.2024.02.008
CR导联心电图的原理及临床应用
Principles and clinical applications of CR lead ECGs
摘要
Abstract
Objective To explore the principles and clinical applications of CR lead ECGs.Methods The CR lead system is a bipolar chest lead system with a common negative electrode.The right upper limb(R)is its common negative electrode,the positive electrode is a point on the chest(C),and each point of V leads were multiply chosen.We can obtain CR lead ECGs by the following two methods.The first method is to make direct acquisition by a conventional ECG machine,with all four limb electrodes connected to the right upper limb and the chest lead electrode connected normally.The second method is to obtain CR lead ECGs through lead conversion based on conventional ECG data.First,the original data of leads such as aVR,V1-V6,V3R-V5R and V7-V9 were retrieved,and then a fixed conversion coefficient CR-Vi=Vi-2/3aVR was used to calculate the target lead(the algorithm was implemented under the compiling environment of Pycharm in Python language);finally,the conversion is completed and plotted.Results Both the direct acquisition method and the conversion method obtained the same CR lead ECGs.However,compared with the corresponding Wilson lead ECG,CR lead ECG in the left chest lead had a similar morphology but slightly great wave amplitudes while CR lead ECG in the right chest lead had similar wave amplitudes but distinctly different wave morphology.The CR lead ECG in the right chest lead had a clear P wave,an upward QRS complex with no wide or deep Q wave,and an upright T wave.Wilson lead ECG had a lower P wave,a downward QRS complex,and could exhibit non-infarction-related wide and deep Q waves and non-ischemic T wave inversion,known as the so-called right ventricular blind zone.Conclusion CR lead ECG opens up the right ventricular blind zone,and achieves equal detection of the left and right ventricles,providing more valuable ECG morphological information for clinical practice and compensating for the limitations of the Wilson chest lead system.It is worthy of being promoted and popularized.关键词
心电图/投影学说/电偶学说/导联向量/Wilson导联/CR导联心电图/导联转换/右心室盲区Key words
electrocardiogram/projection theory/dipole theory/lead vector/Wilson lead/CR lead electrocardiogram/lead conversion/right ventricular blind zone分类
医药卫生引用本文复制引用
景永明,申继红,黄训华,李世锋,樊好义..CR导联心电图的原理及临床应用[J].实用心电学杂志,2024,33(2):141-150,10.基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20220435) （LHGJ20220435）
河南省高等学校重点科研项目(23A52002) （23A52002）
科技创新2030-"新一代人工智能"重大项目(2021ZD0111000) （2021ZD0111000）
